A Week in the Life of a Global Health Fellow

Our Global Health Fellows (GHFs) are hard at work on the ground in Malawi! A ‘typical’ week for them looks as the following:

Monday and Tuesday (Lilongwe): The GHFs usually work in the office on Mondays and Tuesdays, organizing their tasks for the week and attending meetings. Currently they are involved with many on-going projects and are working towards developing new ones, building partnerships and expanding the scope and reach of World Altering Medicine and their partner, Access Health Africa.

Recently they are working closely with Kabudula Community Hospital, the Lilongwe District Health Office and the Ministry of Health to conduct a needs assessment of the Kabudula Hospital to determine the direction of future programs. This project will span many months and takes a lot of community outreach. Planning alone for the needs assessment has taken a few weeks and has included multiple meetings with their community partners at the hospital, Ministry and District Health Office officials, who have granted their full support to continue.

 The beautiful drive to Nkhoma Hospital where we operate the Watsi program!

The beautiful drive to Nkhoma Hospital where we operate the Watsi program!

The GHFs have also started to explore the possibility of addressing the issue of cervical cancer here in Malawi. Cervical cancer is the leading cause of female cancer in Malawi. In the central region on Malawi, there is a backlog of women who require radical hysterectomy via surgery, a potential intervention point for the organizations. AHA and WAM are working to expand their partnerships in Malawi to help address this issue and having boots on the ground is making this possible!

Wednesday (Nkhoma): Every Wednesday, the GHFs travel to Nkhoma Hospital from Lilongwe (about an hour drive) to meet, interview and follow-up with patients who are funded through a program called Watsi, and organized on the ground by the GHFs. Watsi is a crowdfunding platform that provides fully funded surgeries to economically needy patients. It’s a great opportunity for GHFs to meet the patients we are helping and see their reaction to finding out the economic burden of a life-altering surgery is lifted from their shoulders. The GHFs are responsible for submitting the patients to the online Watsi platform. Through this service, we are able to provide $7,000 a surgery a month!

Thursday (Kabudula): On Thursdays the GHFs travel to Kabudula, a community where they have many ongoing projects and are focusing their needs assessment. In the morning, they usually meet with hospital staff to talk about the needs assessment. They also will check in with the pharmacy tech, whom they work closely with to provide essential medicines to the hospital on a monthly basis. The hospital is in need of many medications, including antibiotics, anti-inflammatories and especially pediatric forms of common medications.

They have also started a proposal to build a Trauma Center at Kabudula Hospital. Currently, the hospital only has the space to house their entire trauma unit in a small room, not large enough to fit a patient bed. Hopefully, we will be able to provide a Trauma Unit that can house all of the equipment, patients and staff that is necessary at Kabudula Hospital.

 Current Trauma Room at Kabudula Community Hospital

Current Trauma Room at Kabudula Community Hospital

After all tasks are completed at the hospital, the GHFs head to the Kabudula Secondary School to meet with their community partner there, a teacher at the school. With her, we are able to provide 50 scholarships to Secondary School students every year through our KEEP program. Students are chosen based on economic need and commitment to their education. They also attend the Girls Empowerment group organized at the school every Thursday that includes over 100 girls in secondary school and covers topics such as career guidance, relationships, reproductive health and hygiene and peer counseling.

Friday (Lilongwe): On Fridays, the GHFs are usually busy wrapping up their tasks for the week and often includes things like purchasing the essential medicines to be delivered, research for the needs assessment, cervical cancer issue and trauma proposal, reaching out to potential partner individuals and organizations to expand the organization's scope. Sometimes, meetings are held on Fridays with partners in Lilongwe, including the Ministry of Health and the District Health Office.

Saturday (Kabudula): Once or twice a month the GHFs spend Saturday in Kabudula to work with community members who are unable to meet during the week. Recently, they are gone on home visits to help choose KEEP scholarship students and hosted a meeting with all of the KEEP students and parents.

Keep on the lookout for more detailed updates of the programs that Access Health Africa and World Altering Medicine are running!

Surprise on a Home Visit

Written by Global Health Fellow, Carolyn

 Riding on the back of a kabaza to our scholar’s home!

Riding on the back of a kabaza to our scholar’s home!

During our past surgical trip in partnership with Access Health Africa, I was responsible for helping to organize the surgical patients, interview them and discharge them. During this process, I got to know some of them well, and was fortunate enough to see them before and after anesthesia, when they were anxious, excited and then thankful for a successful operation. Knowing that our patients were coming from a very large catchment area, including some villages that are hard to reach, I was not sure if I would ever see some of them again.

A few weeks after the surgical trip, I was with one of our community partners, a teacher at the Kabudula Secondary School, conducting home visits for high school students we are sponsoring this school year through our KEEP program. I met the teacher at the secondary school and we proceeded via kabaza (bicycle with a passenger seat on the back, my first time riding one!), to a remote village to meet a student and his family. The ride was about 20 minutes through the countryside on a dusty road.

Along the way, I was casually waving and greeting everyone we passed, and I saw one of the mothers of a young female patient we operated on during surgical week! She started laughing, waving and yelling to get my kabaza to stop. I recognized her instantly and hopped off to greet her. She gave me the biggest hug, high fives and a handshake and through laughter and mixture of English and my own broken Chichewa, I asked how her daughter was doing.   

Her daughter is 14 years old and had a ganglion cyst on her wrist. She said she has healed fine and is pain free! Before her surgery, she was unable to complete her housework because the pain was too bad and had the cyst for 6 years.  Her and her mother walked to Kabudula Community Hospital along this dust road 3 different times to see our surgical team. I walked it back from the home visit, and it was not an easy journey, it took over an hour with no respite from sun or dusty wind.

I couldn’t believe that I saw one of our patients’ parents from surgical week, and the fact that she recognized me, embraced me the way she did and again thanked me for our services, was such a highlight of my time here. She was beaming.

 Our patient, Coletta (right) and her mother.

Our patient, Coletta (right) and her mother.

Meet KEEP Scholar Sandra Ziwasi

Sandra is a 19-year-old student at Kabudula Community Day Secondary School (KCDSS) where she is in form 4. Sandra is supported by the KEEP Program, without which she would be unable to afford school fees. Because her village is too far for her to walk, Sandra rents a small room in Kabudula, so she is better able to attend to her studies. This self boarding has been a wonderful opportunity, Sandra stated. It allows her to proceed in her education and fulfill her goals, with her ultimate goal being to attend Nkhoma Nursing School.

Advisory Board Member Owen Talks About Surgery at Nkhoma

Owen Chipewa, Clinical Officer, has been in residence at Nkhoma Mission Hospital for three years and is an integral part of the WAM/Watsi team. Owen, who has been a clinical officer for 7 years, said early on his life he felt drawn to medicine, surgery especially. After completing his Clinical Medicine Diploma, Owen headed to Nkhoma to practice surgery and family medicine.

            “I wanted to come to Nkhoma because this is one of the best hospitals in the country,” Owen said in an interview in October 2017. “This hospital is one of the best facilities in the country to do surgery, the hospital is able to meet the needs of the patients and the reputation of the surgical staff and the facility itself is excellent”.

            The surgeries Owen performs range from Watsi-funded procedures such as prostatectomies, hysterectomies, and hernia repairs, to trauma and cesarean sections. But Owen’s day does not start with scrubbing in; everything starts with a team meeting. “Normal surgery days are Tuesday and Thursday, sometimes all day, but occasionally we have an emergency cesarean section or a trauma patient who needs to be in theater right away”, Owen explained. “The OR can be very, very busy!”

            When asked how the Watsi and WAM partnership has worked for the hospital, Owen did not hesitate with his answer, “Watsi is the best funding institution we have. This program helps so much. I have patients come with no shoes, in rags, desperate for help with no way to pay for treatment. Now, they can have their operations and live a healthy, full life. This program has impacted the community, and the country. This work transforms lives, and I get to see my patients leave here whole and well.”

Our Model-How Our Partnership With Watsi Works

WAM is a proud partner of Watsi, a groundbreaking crowdfunding platform that is changing the way medical procedures in impoverished areas of the world are funded.

Based in San Francisco, Watsi enables anyone to directly support life-changing healthcare for people around the world by connecting patients and donors online. They find patients by partnering with programs like ours that have a strong, positive relationship with local medical communities and a commitment to provide reliable support wherever possible.

Our partnership is an incredibly effective way to extend care to the people in our community who need it most like Chisomo, an 11 year old who needs a $334 surgery to repair a hernia. We select people to be Watsi patients if they are afflicted with conditions that, if left untreated, would severely impact their quality of life, and if they can not afford the treatment needed. We then submit profiles of these patients, which includes basic information on the treatment and individual patients’ stories, to the Watsi team. Once approved, donors read these profiles and contribute as little as $5 for the needed procedure. In order to maximize our focus on helping people with few resources, especially in rural areas, we only submit patient to Watsi whose treatments cost less than $1,500.

100% of donations through Watsi go directly to funding patient procedures. This includes medical supplies, diagnostics, transportation, food, lodging, and follow-up care, covering an entire hospital visit so patients can receive the care they need without worrying about paying for it out-of-pocket. With Watsi, WAM provides low-cost, high-impact procedures to as many patients as possible, revolutionizing the funding model for non-profits.

Treating Cervical Cancer

Ester is a 39-year-old mother of five from a village called Msewa in Malawi's Central Region. She likes cooking nsima, the staple food in the Malawian diet made of maize meal, and washing clothes. A year ago, Ester started experiencing symptoms that led to a diagnosis of cervical cancer. Her symptoms made it difficult for her to farm and take care of her children.

Cervical cancer is extremely prevalent in Malawi for many reasons, including early age of sexual initiation, poor access to screening, and high HIV rates. If changes in cervical cells are not found early through routine screening, they can progress to cancer, which is what happened in Ester's case. By the time she arrived at the hospital her only treatment option was a hysterectomy, which she could not afford. A hysterectomy can be a life-saving solution for patients like Ester.

Luckily, the World Altering Medicine team and clinical staff identified Ester at Nkhoma Hospital as a candidate for Watsi funding. We explained the process to her and she was overcome with joy that her family's wellbeing would not have to be jeopardized by trying to afford the surgery. On September 29th, Ester underwent a successful hysterectomy and is now likely cancer-free. 

When we visited Ester after her operation, she and her family were feeling happy and excited. Ester said, "I am giving thanks to the doctors and to Watsi."

The ability to fund Ester's surgery and surgery for many women with cervical cancer is a result of generosity from people like you. Let's continue improving access to quality healthcare together,

KEEP Coordinator Blessings' Graduation

We are very proud of our KEEP Coordinator, Blessings Ackim, on her graduation from Nkhoma University with a Bachelor's degree in Education.

Blessings works as a teacher at Kabudula Community Day Secondary School (KCDSS), where she serves as our KEEP Coordinator. She is extremely dedicated to her students and leads many extracurricular activities including a girls empowerment club, computer club, and community service activities. As the only female teacher at the school she is viewed as a role model and resource for the teen girls, who face many barriers to staying in school. 

While studying, Blessings continued to work and traveled twice a month to Nkhoma, a town approximately two hours from Kabudula, to study during the weekend.

Well done, Blessings!

The Postnatal Ward Complete

WAM has been working with our partners, Warm Heart For Malawi and Kabudula Community Hospital, to renovate and expand the postnatal ward. 

The hospital sees an average of 15 deliveries per day and each mother stays with her newborn in the postnatal ward for 48 hours following delivery. 

Before, the ward was overcrowded. Women and babies were sharing beds and sleeping on the floor. The windows were broken and toilets were not functioning. Women would leave the ward to use a pit latrine outside in the days following birth. There was no working hand sink in the entire ward.

With generous help from Warm Heart For Malawi and in collaboration with the hospital team, the ward has now been expanded and will fit 20 beds, almost double the previous capacity. The walls are freshly painted. Three flush toilets, two showers, and hand sinks are working and will provide a significant increase in the sanitation and hygiene of the ward. 

Sadly, maternal and neonatal mortality rates are extremely high in Malawi, but many of these deaths are preventable. Our hope is that, through this project, women and newborns will have a safer experience in those critical 48 hours following childbirth.

A Visit To Khongoni Health Center

Kabudula Hospital is the referral center for eight community health centers in the catchment area. One of these health centers is Khongoni serving a population of 54,000 people and refers patients to Kabudula each week. Built in 1970 this health center is approximately 30 minutes’ drive from Kabudula Hospital down a bumpy dirt road. Upon arriving at the health center WAM staff were welcomed by Health Surveillance Officers and quickly put to work in the malaria testing and immunization room while waiting to speak with the nursing assistant in charge. 

WAM staff were happy to see that of the six malaria rapid tests administered none of the women and children had malaria. Following the malaria testing, WAM staff recorded tetanus injections for pregnant women in their patient profile booklets. Although malaria tests and tetanus injections were available that day, this health center suffers from many shortages and barriers to providing quality health care services. Electricity was bought up as the top challenge facing this facility - with no electricity the health center is less able to deal with complicated deliveries and mothers are at risk during child birth. Additionally, they have not received handwashing soap in three months and experience a stock-out of vital drugs every two weeks. With the support of WAM, medications can be sought from Kabudula pharmacy to re-stock medications when a stock-out occurs.

General Surgeon Visits Kabudula

This month WAM partnered with Access Health Africa to bring quality surgical care to the Kabudula Community.

Baker Henson, a general surgeon from the US and Cofounder of Access Health Africa, volunteered to provide patients in the Kabudula Health Catchment Area with needed surgical treatments.

The first day we spent at the hospital we brought with us a huge duffel full of surgical supplies; sutures, dressings, head lamps, gloves, gowns, etc. We filled a spare room in the surgical ward and immediately turned to the line of patients who were eagerly awaiting our arrival. Each patient was screened and registered for surgery that week.

For the next several days, a combination of WAM and Access Health Africa staff returned to the hospital to perform surgeries that patients could otherwise wait years to access, if at all. A few of the days we had no access to electricity, but the surgical team worked on, using headlamps. 

Surgical care can be very difficult to access in Malawi, particularly in rural areas like Kabudula. Bringing expertise and care to the local health facility removes many barriers that patients face and enables them to receive quality treatment. We are committed to improving access to care in this community, and hope to serve even more surgical patients in coming years.